Anesthesiology PGx.
Information for your anesthesia team. A focused test of the BCHE gene, which affects how the body breaks down certain anesthesia drugs such as mivacurium. One saliva sample, run in our CLIA-certified lab, with results your prescriber can refer back to.
- One sample, no blood draw
- Results in 3–7 business days
- Share with any prescriber
Panel
1 gene · BCHE
Sample
Saliva or cheek swab
Results
3–7 business days
Price
From $289
What we test
Medications and the genes behind them.
See how your genes may affect your response to certain anesthesia medications. Review your results with your prescriber.
Mivacurium
Reduced butyrylcholinesterase activity can prolong muscle relaxation and delay recovery after this anesthetic agent.
BCHE gene
The one gene on this panel — it determines how quickly your body clears certain muscle relaxants used under anesthesia.
Who this is for
The same dose can work differently in different people.
Preparing for surgery
Reduced butyrylcholinesterase activity can prolong muscle relaxation and delay recovery after some anesthetic agents.
A difficult past anesthetic
Waking slowly or breathing trouble after a prior procedure is the classic reason to check BCHE.
Family history
A relative who had an unexpected reaction to anesthesia suggests testing before your own procedure.
Is this test right for you?
You have surgery or a procedure under anesthesia coming up.
You woke slowly or had breathing trouble after a past anesthetic.
A relative had an unexpected reaction to anesthesia.
You want results your surgical team can review in advance.
Your surgeon or anesthesiologist suggested genetic testing.
You want results you can keep for future procedures.
Answering yes to even one of these is a good reason to test before your next procedure.
Before you order
Total price
From $289
One-time price, shown in full at checkout before you pay. No separate fee for the kit, return shipping or the healthcare provider order.
What's included
Kit to report
A saliva or cheek-swab kit with instructions, a prepaid return label, the healthcare provider order, genetic testing in our lab and a gene-drug report in your secure portal.
When to expect results
3–7 business days
After the lab receives your sample. You are notified as soon as your report is in your secure portal.
The science
What the evidence says about getting tested.
Butyrylcholinesterase (BCHE) is the enzyme that clears succinylcholine and mivacurium, the short-acting muscle relaxants used to intubate you at the start of an anesthetic. Most people break these drugs down within minutes. People who inherit reduced-activity BCHE variants clear them far more slowly, and the muscle paralysis — including the muscles that keep you breathing — can last hours instead of minutes until ventilation takes over.
1 in 3,200
people inherit two reduced-activity BCHE variants — roughly 1 in 3,200 in studied populations.
Source: Clinical genetics reviews of BCHE deficiency
About 1 in 25
people carry one atypical BCHE copy, giving partly reduced enzyme activity.
Source: Clinical genetics reviews of BCHE deficiency
Hours
of paralysis instead of minutes is the classic signature of severe BCHE deficiency after succinylcholine.
Source: FDA succinylcholine labeling
1
gene — BCHE — explains most prolonged blockade cases not explained by dosing or drug interactions.
Source: BCHE pharmacogenetics literature
How often should you test?
Test once — your BCHE genotype doesn't change. The right moments are before a procedure likely to use succinylcholine or mivacurium, after any anesthetic from which you recovered unusually slowly, or when a close relative had an unexpected reaction. A result on file can be shared with your anesthesia team before every future procedure.
References
- U.S. National Library of Medicine, DailyMed — succinylcholine chloride prescribing information: warning on prolonged apnea with pseudocholinesterase deficiency.
- PubMed literature review — butyrylcholinesterase deficiency and prolonged neuromuscular blockade after anesthesia.
- U.S. National Library of Medicine, DailyMed — mivacurium chloride prescribing information.
Questions people actually ask
Bring data to your next procedure.
One sample, one flat price, a report your surgical team can review before pre-op planning.